Allogeneic bone marrow transplantation in the developing world: experience from a center in India

Bone Marrow Transplant. 2001 Apr;27(8):785-90. doi: 10.1038/sj.bmt.1702869.

Abstract

We describe our experience of setting up an allogeneic BMT program at the Christian Medical College Hospital, Vellore over a period of 13 years, from October 1986 to December 1999. Two hundred and twenty-one transplants were performed during this period in 214 patients, with seven patients undergoing second transplants. Indication for BMT were thalassemia major - 106 (48%), CML - 30, AML - 35, ALL - 10, SAA - 22, MDS - six and six for other miscellaneous disorders. The mean age of this patient cohort was 15.6 years (range 2-52). Graft-versus-host disease of grades III and IV was seen in 36 patients (17%) and this was the primary cause of death in 20 patients (9.2%). All patients and donors were CMV IgG positive. Sepsis was the primary cause of death in 16 patients (7.4%), 10 bacterial, four fungal and two viral. One hundred and ten of this series of patients are alive and disease free (50%) with a median follow-up of 24 months (range 2-116). These results are comparable to those achieved for patients with similar disease status in transplant units in the Western world and cost a mean of US$15 000.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / economics
  • Bone Marrow Transplantation / mortality
  • Bone Marrow Transplantation / statistics & numerical data*
  • Cause of Death
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Developing Countries*
  • Drug Therapy, Combination
  • Female
  • Hematologic Diseases / economics
  • Hematologic Diseases / mortality
  • Hematologic Diseases / therapy
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Regional Medical Programs / economics
  • Regional Medical Programs / standards*
  • Survival Analysis
  • Transplantation, Homologous / economics
  • Transplantation, Homologous / mortality
  • Transplantation, Homologous / statistics & numerical data*
  • Treatment Outcome